Author Archive

Playing Nice in the Sandbox – everyone has a wonderful project experience

As a Project Manager for an Owner, is it our role to play nice in the sandbox or be the playground bully? Being an effective Project Manager for an Owner means different things to different people. A project will typically be completed according the schedule and budget established between the General Contractor and the Owner unless changes to the scope are agreed to by all parties. But sometimes the leftover taste in the mouth about how successful the project went, can be directly attributed to the personality of the Project Manager.

Many times the Project Manager can adopt the “playground bully” role, and are known to take sides with the Owner over the rest of the project team. Whether the issues that arise are schedule, cost, construction issue, or completion date related, everyone tends to leave the project feeling as though the project was a struggle to some extent. This playground bully attitude can create defensiveness in the project team and ultimately tends to create an “us vs. them” project atmosphere – where no one really wins – especially the Project.

On the other hand, some Project Managers take on the “playing nice in the sandbox” attitude. This doesn’t just mean letting the Owner or the General Contractor have their way, because this alone can lead to a dysfunctional project team dynamic. An exceptionally professional Project Manager has the ability to openly (and calmly) discuss all project issues as thoroughly as possible, with the entire team, while simultaneously gathering information to provide to all parties in order to help reach a resolution. This resolution may not be agreeable to all parties all the time, some may favor the Owner and some may favor the Construction team, but the resolution is one both sides have the opportunity to evaluate thoroughly from each other’s perspective.

Project goals and ground rules need to be established early! An experienced Project Manager knows it is not only how project issues are addressed but also how the “playground rules” were established early on so everyone knows the critical, non-negotiable ins and outs of the project (budgets, schedules, project requirements, etc.). These must be communicated to ALL parties (Owner, Architect/Design Team, Construction Team, consultants, etc). Like any project, a good foundation is key to a solid building. Another critical piece of information to create before the project is underway is a responsibility matrix outlining who is responsible for each detailed aspect of the project in order to make it successful. Everyone then knows their responsibility to the team.

Everyone on the Team signed the last beam to be placed at Wyoming Medical Center

The Project Manager is responsible for enforcing these agreed upon rules, roles and responsibilities. The critical part of this process is how this is accomplished. The Project Manager must always conduct themselves with integrity and without prejudice, never making assumptions (good or bad). It’s about having the poise and the moral courage to “do what is right” – for either side. If it’s right, then neither side can argue.

Taking your kids to the park was always more enjoyable when they played nicely in the sandbox. Completing a project, large or small, is never a “walk in the park” but it can be an enjoyable experience if managed with the proper attitude from day one.

The last beam placed in Casper, Wyoming for the Wyoming Medical Center

Knowledge is power is an old adage, but it certainly rings true every day in project management. That power can be abused, however. You don’t want to simply hold onto the information in order to retain the power, but instead use the power of the information to empower your team.

We have seen first-hand how transparency leads to successful projects and it always seems to come back to communication. Good communication is vital to any and every project. One of the best communication tools we have experienced is to ask team members at the end of every meeting if there is anything about the project that is keeping them up at night. Stressing in meetings that you want to know the good, the bad and the ugly about the project helps ensure that all details, whether pretty or not, stay in the light. It is better to be able to make informed decisions based upon all the information than on only part.

Time is another crucial consideration when it comes to transparency. It is simple. The more time that passes without the owner knowing the issues, the more detrimental that problem will become. They can only use their resources to assist in solving the issue if they know about it.

Transparency equals collaboration. Transparency develops trust within the project team and keeps every team member working toward the common goal. Frequent face to face team meetings with all accountable parties together will help make this happen. Less interaction allows for distance and disconnect to creep in and cause problems. Noble Energy likes to have meeting outcomes clearly defined at the beginning of the meeting so everyone knows what exactly they are working towards. Meetings are considered safe, productive places to discuss issues without judgment or finger pointing.

As one of our standard services, Milestone believes in capturing the moment and holding a separate, distinct meeting with the main stakeholders of a project: The Owner, The Design Team, The General Contractor, Key Vendors (IT, Furniture, Major Equipment) and Key Sub Contractors to review the project process and develop a list of “Lessons Learned”. In our most recent “post mortem” of a major project, we developed three categories for our topics: Breakthroughs (issues/ideas the team came up with that were truely unique and created outstanding avenues for team successes), Alignment (processes we developed in the project that aligned our team) and Opportunities (processes that would need tweaking or solutions for our next project).

By developing an atmosphere of “safety” and “constructive criticism”, where topics and issues were discussed in a collaborative session, we avoided the typical pitfalls of Lessons Learned meetings. Those pitfalls are: Blame, Humiliation, Fear and Anger.

Instead, we heard common themes that were subconsciously promoted and reinforced throughout the design, construction and occupancy phases of the project….we heard “interdependency” and “transparency”. Words that I believe, quite frankly, are mis-used and tossed about in a very casual way. Lets look at these words and the actions that demonstrate their importance on a major capital construction project.

INTERDEPENDENCY

The definition of Interdependency is “..two or more people or things that are dependent on each other.” In our design and construction meetings, as a matter of habit by our Owner, he would ask a simple question as we closed the meeting “..team, what is keeping you up at night, and how can I help?” Now, at first, we just took this as a the Owner being nice and subtly telling us that he appreciates the team working the issues of the day. However, after a few meetings, he began to hear about some major concerns in design or in construction. A few of these issues, the Owner took back to his company’s own employed engineering staff, where their team of engineers worked on these issues and brought solutions to the design and construction teams. Other issues were solved by other members of our Construction and Design Teams that were unrelated to their role on the project.

Example: The issue of delivering 1200 sets of office furniture without a loading dock that could handle a tractor trailer rig, was solved, not by the furniture vendor (who’s problem it was), but by the architect.

Results: A true atmosphere and philosophy was created and acted upon to have the entire team hear the concerns of a team member, and then to formulate ideas of how we call could help resolve the issue, and perhaps, in so doing, achieve a Breakthrough!

Here at Milestone, we have so much good information that is sent out over a variety of media, that we thought it would be a good idea if we brought up some past articles from our quarterly newsletter, Milestone On Times. This article on one of our Pharmacy Renovations, was in the October 2010 issue of MoT.

St. Luke’s Episcopal Hospital and St. Luke’s The Woodlands Hospital recently completed renovations to bring their pharmacies into compliance with USP 797 guidelines.

At St. Luke’s Episcopal Hospital, it was determined by the Pharmacy Department that a new negative pressure chemotherapy prep room was needed in order to comply with USP 797. Because the existing clean room and pharmacy work rooms were required to remain operational during the entirety of the construction, much time was spent planning the construction and occupation sequence. Careful coordination of the equipment relocation ensured that the pharmacy suffered no downtime; the staff always had ability to prepare IVs and chemotherapy products.

At St. Luke’s The Woodlands, the renovation included the expansion of the existing pharmacy and lab by nearly 1,300 SF. To meet the requirements of USP 797, a new chemotherapy prep room, IV prep room and an anteroom were added. In order to maintain pharmacy operations, the project was design to be completed in three separate phases, which would require a minimum of three separate TDSHS inspections. To renovate the existing clean room, a temporary clean room was setup outside of the project area so that operations could continue. And with a little creativity, the project team was able to sequence the construction (rather than complete the work in phases) so that only an 80% and 100% inspection were required.

Milestone Project Management was engaged by St. Luke’s Episcopal Health System to manage the design and construction process for both projects.

PhiloWilke Partnership (Architecture) and Telios (MEP) comprised the design team for the St. Luke’s Episcopal Hospital renovation. WS Bellows’ Medical Center Renovation Team served as the Construction Manager.

For the Woodlands’ hospital, HGA provided both architecture and MEP engineering services. Forney Construction was the Construction Manager.

“It’s the most wonder-ful time of the year!” so says the famous Christmas song sung by Andy Williams. I happen to agree.

I’m sure by now you all have seen our Holiday postcard for 2012. In tribute to some of our favorite chefs and the season, we are cooking up some good things here at Milestone and we thought we’d share a recipe or two with you.

Happy Holidays from all of us!

First up is an alternative to eggnog that is a holiday tradition in my house – Brandy Milk Punch. I believe this originated somewhere in New Orleans, but the recipe here is one I received years ago from my aunt, Pam Klawitter:

Brandy Milk Punch

Ingredients:

1 ¾ – 2 cups brandy

1 ½ pints half & half

1 ½ pints heavy cream

1 tsp. vanilla

8 tsp. powdered sugar

1 ½ pints vanilla ice cream

Directions:

Mix together brandy, half & half, cream, vanilla, and powdered sugar.

Cover and chill for 3-4 hours or more.

Whisk mixture thoroughly and add vanilla ice cream.

Return to refrigerator for 1-2 or more hours. Sometimes I serve it right away.

Stir/whisk thoroughly before serving.

Yield: Approximately 2-3 quarts. Recipe can be halved or doubled.

Need a little snack to go with that Christmas cheer in a glass? How about some homemade Peanut Brittle?! This recipe comes from the mother of one of my elementary school classmates, Ms. Sharon Francis. Wherever you & Meredith are now Ms. Francis, thank you!

MPM Carrot Crew

Microwave Peanut Brittle

Ingredients:

1 cup sugar

½ cup light Karo syrup

1 cup raw peanuts, unsalted

1/8 tsp. salt

1 tbsp. butter

1 tsp. baking soda

Directions:

In a large microwavable bowl, mix together sugar, Karo, and peanuts.

Microwave on high for 4 ½ minutes. Remove and stir.

Microwave on high for 4 ½ minutes. Remove and stir. Add in salt and butter.

Microwave on high for 2 ½ minutes.

Remove and stir in baking soda. Stir until light and foamy.

Pour mixture onto greased cookie sheet.

Allow to cool, then break apart.

NOTE: This recipe should not be doubled. You must make it twice, which I do as it disappears very quickly.

Yield: 8-16 ounces.

As I never could figure out how to cook a turkey and have found that others will do it for you and quite well, I give you the recipes for three of my favorite holiday side dishes:

Green Bean Casserole – everyone has a recipe for this, but I love the one my Mom, Mary Klawitter, makes with a bit of soy sauce.

Green Bean Casserole

Ingredients:

1 1/3 can French’s onions

2 cans green beans

1 can cream of mushroom soup

½ cup milk

1 tsp. soy sauce

dash pepper

Directions:

Mix together all ingredients, reserving a small amount of the onions.

Bake at 350° for 25 minutes.

Top with the reserved onions and bake for 5 minutes longer.

Yield: Serves 4-6 as a side.

Potato Casserole – mashed potatoes are awesome, but if you want something a little different, these are great too – from the kitchen of my Mom’s friend, Elizabeth Bales.

Melt ½ stick oleo and add to Special K. Spread on top of potato mixture.

Bake at 350 degrees for 30-40 minutes. (Check and cook longer if needed.)

Yield: 4-6 side servings.

Last, but certainly not least, Yummy Macaroni & Cheese (like Luby’s makes only better IMHO). Can’t remember where I first found this recipe, but I’ve tweaked it a bit over the years and it always gets rave reviews.

MPM helping the Houston Food Bank

Luby’s-like Macaroni & Cheese

Ingredients:

8 oz. dry elbow macaroni

2 tbsp. nonfat dry milk

2 tbsp. flour

1 tbsp. butter, melted

1 ¼ cup boiling water

3 cups American cheese, grated (I buy a block and grate it myself. It can usually

be found near the Velveeta.)

¼ tsp. salt

Directions:

Cook macaroni according to package directions. Drain & set aside.

Heat oven to 350°.

In a large bowl, mix dry milk, flour, and butter. Gradually add boiling

Moving on to desserts…the best part of the meal for many of us. For those who don’t know me, I confess that I am a very poor speller (thank God for spell check among MANY other things) and I can never remember whether dessert is with one “s” or two. I even misspelled it on the dinner menus for the rehearsal dinner for our wedding. After that a friend gave me a trick to this one – you don’t want as much desert as you do dessert, so more “s’s” please!

This simple but delicious Apple Crumb Pie is from the mother of my best friend growing up, Ms. Judy Rader.

With an electric mixer, combine the cake mix, peanut oil, eggs and flavoring

together. Beat together until well mixed.

Refrigerate 2 hours.

After dough has chilled, gather dough by teaspoonfuls and roll into small

balls (about 1 inch in diameter). Put un-used dough back in the refrigerator.

Roll cookie balls in the powdered sugar.

Place balls on ungreased cookie sheet.

Bake 8-10 minutes, cookies will flatten out after they are baked.

Yield: 3 dozen cookies.

Finally, if you have a few guests and need a morning after breakfast, here is the casserole for you. The recipe comes from our family friend, Lynda Burgess, who used to make it when we visited them in Colorado. They’re back in Texas now, but this dish is a winner in both cold & hot climates.

Breakfast Casserole

Ingredients:

3 eggs, slightly beaten

2/3 cup milk

1 can cream of celery soup

1+ cup American or cheddar cheese, grated

2 cups frozen hash browns (do not cook)

1 lb. breakfast sausage, cooked, drained, & crumbled

bread crumbs

Directions:

Combine soup, milk, eggs, & cheese.

Add hash browns and sausage.

Pour into a 7×10 or 8×8 inch greased baking pan.

Sprinkle with bread crumbs and additional cheese.

Bake at 350º for 40-45 minutes or until set. (NOTE: Can be made the night

before and refrigerated – if so, you may need to cook 5-10 minutes longer.)

Yield: 6-8 servings.

Everyone here at Milestone wishes you Happy Holidays to all, and to all a good night

At Milestone we take ownership and great pride in our client’s projects. There is no motivation we have other than moving the project from a vision to a reality.

Although Milestone is comprised of architects, engineers and contractors, we do not construct, nor do we design – what we do is extend the clients culture and philosophies through ourselves and into the project. We are a conduit, an extension of staff, we organize and facilitate.

We organize and facilitate, not only for our Owner’s, but for the entire project team. We account for the issues and chase down tasks for the design team. We proactively work with the construction team on schedules, budgets, site logistics and other hurdles that they encounter.

We position ourselves at the center of the communication stream, brokering and recording the decisions on issues, tracking the outcomes. We’re the one-stop-shop of project information, johnny on the spot with answers when anyone on the team has questions. We don’t let anything “get lost in the details” because we know it’s those details that can make or break a project.

We have a client that “doesn’t like project management firms”. Period, full stop. Milestone has been working for him for almost five years. I believe that this is because we are not a “project management firm” in his mind. We are on his team. He is the quarterback, we do the downfield blocking…the front line work…we are the unsung Tackles and Guards that provide the Receivers and Running Backs the opportunities to move the ball forward and succeed.

In the end, its about passion. The zeal to be a part of something bigger than ourselves, and believe me – or clients are doing some pretty amazing stuff. It is personally fulfilling to us on a very base level to have brought the first Cyberknife to Houston, the first Gamma Knife technology to The Woodlands, building a state of the art laboratory in which Dr. Doris Taylor is growing hearts out of stem cells, to extending the corporate culture of the leader in natural gas exploration – these clients are changing the lives of so many people worldwide. Its the knowledge that we are doing projects to help people not only in our communities, but in lands that I may never see. Passion.

Scott LaTulipe, football fan, is anticipating the beginning of the new season. Ask him about his fantasy football team!

“If you’re lucky enough to find a guy with a lot of head and a lot of heart, he’s never going to come off the field second.” – Vince Lombardi

Well, the suspense is over, the last shoe has dropped with the Supreme Court upholding the majority of the Affordable Care Act. Now it is time to begin implementing the various aspects of the new law.

Throughout the last half of the 20th century the U.S. healthcare industry has been impacted, directed and increasingly regulated by the federal government. Regulation, from the Hill-Burton Act of 1946, Medicare in 1965, Community Planning and it’s reliance on the Certificate of Need to regulate the supply of healthcare of the 1970s, to DRG’s in 1983 and the Balanced Budget Act of the mid 90s - all have driven capital facility responses. Every act has had it consequences.

The Affordable Care Act may be another and perhaps the first real serious step to controlling healthcare cost. Or it may be just another set of rules to be gamed by very smart healthcare, medical and insurance administrators. Regardless, there are drivers that will have significant impact on the programming, planning, design and construction of healthcare facilities. Two factors will drive the development of facilities:

1) Tens of millions of Americans will have access to healthcare insurance.

2) Reimbursement rates will go down.

These two factors more than anything else will become the challenge for facility design and construction – to support the institution in its efforts to maintain their economic viability and healthcare mission.

In my opinion, the most likely facility responses will include the demand for greater staff efficiency, the optimization of productive care and higher utilization rates.

Staff Efficiency

We’re going to hear a lot more about staff efficiency, which is having the right expertise, in the right place, at the right time and with the necessary tools at hand to support the care. Every moment will count; it may not be life-supporting but it could make the difference in having a profitable operation and therefore having healthcare available. Look for highly specialized medical treatment centers to develop around a specific medical need or procedure. Efficiency will drive the further specialization (assuming the volume is there) to reduce the cost of the treatment.

Productive Medicine

Productive care will require that patients receive the least amount of care at the point that it does the greatest good. Preventive and early intervention care will drive the need for more outpatient and physician support care centers. (Better to get a pneumonia vaccination before you get sick than a shot of penicillin when you get sick or spend a week in an intensive care unit fighting pneumonia). Look for the development of more immediate care or walk-in care centers; the development of community, neighborhood and school-based clinics will lead the way to keep people out of the hospital. Long term, the need for hospital beds should begin to decline as productive use of medicine drives down the demand for beds. Hospitals should evolve into critical care centers and will only serve the sickest of the sick.

Utilization

Closely associated with Productive Medicine is the utilization of equipment and facilities. Utilization rates must continue to increase. Facility programming and design must allow for patient flow and staff efficiency that keeps the equipment and facility working. An extra 80 to 100 square feet for an additional dressing room may be a great investment if it allows for another MRI test every 8 hours. Planning will have to stop basing space programs on “average” patient utilization rates and start basing it on desired optimization rates and return on investment.

There will undoubtedly be other drivers and responses that will, from time to time, come to the surface and create opportunities for new facilities – this is after all the United States, home of entrepreneurs. The basic intent of the Affordable Care Act is to make healthcare accessible to the millions of citizens without healthcare insurance and to reduce the total cost of healthcare. However, it may be the unintended consequences that provide the greatest facility challenges and opportunities for the future. Stay tuned to this blog as we explore the healthcare landscape for the first signs of the unintended consequences of more federal regulation.

Bill Eide has been developing, planning and building healthcare facilities ALMOST since the Hill-Burton Act was enacted.

Beginning June 1, 2012, the Business Journals in 43 cities across the United States are hosting a social media competition. Companies had to apply to be included in the competition, and Milestone Project Management was one of the firms to be selected to compete. We are very excited, but we NEED YOUR HELP!!!

I know what you are saying….”but Scott, how can I help Milestone win this competition, what with my busy work day and all??”

The first round of competition ends on June 19th, with the top 8 companies in our “Houston <100 Employees” bracket moving on to compete for the overall Houston “Houston <100 Employees” winner, to be announced on July 17th.

From there, all the city champs will be competing against each other nationally, with the three size category winners announced on September 11th.

WE ARE IN IT TO WIN IT!!!

Milestone has a reputation for customer service and support, which is manifested through the philosophy of “Project Steering”.

Project Steering is a framework for decision making that provides expertise, guidance and assistance to the Owner. Through project steering Milestone defines the issues, objectives, requirements and goals to enable the Owner to make decisions quickly and with confidence.

The tenants of Project steering are to fully understand the people and positions, policies and procedures and project objectives (cost, schedule, market strategy, etc.). By building your knowledge bank while familiarizing yourself with schedules, project cost estimates, and contracts, the project manager becomes armed with the basic information of the “ground rules” of the project and then can craft an implementation strategy supported on that foundation.

Collaboration is the key to continuously refining the project data and assigning tasks and accountability to the project team. We ask your team members for commitments and hold them accountable for their actions. We lead meetings – communicating and facilitating discussions for decision making and information gathering – these are the core functions of a Milestone project manager that is implementing Project Steering. We believe that the Owner, through the project manager, should maintain the project documentation and be responsible for meeting minutes and action items. We are accountable to our team, we provide timely information, seek out questions and answers and remain accountable after the project is completed and occupied.

We invite participation in lessons learned sessions and when required we provide constructive criticism and implement plans for improvement.

One of the most important things we do is say “please” and “thank you.” We also Smile – it sounds trite and perhaps a little naive, but its one of the key components to this philosophy, and its very easy to do every time.

Milestone recommends that every project manager read Barbara Bryson’s “The Owner’s Dilemma” for more detailed information on the philosophy of Project Steering.

Success is defined through metrics. We work to quantify success based on the Owner’s measuring the basis in objectives: time, cost, project requirements and objective/definable goals. We also seek to quantify the intangibles such as the level of satisfaction with the outcomes and the willingness to work together on future efforts.

At MPM we apply our efforts and our expertise to help you achieve greater growth and profitability through five “Smart” Services.

Smart Source and Partnering. The demand for capital project management ebbs and flows with your strategic plan. When the demand grows for project management it is more cost efficient (profitable) to use our professional project management team rather than hiring and maintaining a staff. Retain the leadership of capital projects within the executive suite but let us provide the staff you need. The money you save on not having an in-house staff can be invested in other more profitable ventures.

Smart Negotiation. Negotiate your facilities repair and maintenance supplier/vendor contracts. Because we are in the market every day we can help you evaluate their proposals to make sure the “favored customer” rates aren’t above current “market rates.” Competitive pricing can result in significant savings and increased profitability.

Smart Tools. Use our smart management tools to create project scope documents, capital requests, strategic capital budgets and track project development. We will help you establish the controls and reporting mechanism so you always know the status of your projects and are always in a position to make knowledgeable (information and data based) smart decisions. Our tools will help you use project data to drive project decisions and proactively manage the project.

Smart Schedules. The shortest schedule isn’t always the best schedule. Unrealistic short schedules can drive the cost of a project up and result in operational problems in the future, which reduce profitability. Smart schedules allow you to take advantage of the market place and your capital. Our expertise in schedule management will help you get your project to market at the right time and at a cost that will result in potentially greater future profits.

Smart Planning and Expertise. Applying expertise at the right time, to the right areas and issues results in better projects. Better projects have more potential to produce greater profits. Putting your money where it will do you the most good (location, quality materials, efficient design) is the result of smart planning and expertise. Making smart decisions based on real expertise throughout the duration of the project is the best way to assure reaching your return on investment goals.

There are more ways we can help your organization be profitable. From leadership to stewardship we are your partners in creating better, more efficient, more viable healthcare facilities regardless of the obstacles that have to be over come.

Please call Bill (713-523-2552) if you would like to discuss how we could help your hospital be more profitable and visit our web site (www.milestonepm.com) for more information about Milestone Project Management.